Senate Bill To Make Va Deaths Public

WASHINGTON — The Senate has approved legislation to tighten quality standards in Veterans Administration heart surgery programs, while making public some patient death and injury rates.

The bill, introduced by Veterans Affairs Committee Chairman Frank H. Murkowski, R-Alaska, is the first attempt in Congress to mandate medical ``quality assurance`` policies in the 172-hospital VA medical system, the nation`s largest.

The measure follows disclosure by the Fort Lauderdale News and Sun-Sentinel that more than a dozen VA heart surgery programs reported excessive death rates in recent years.

Under the bill, VA officials would be required to report death statistics for heart surgery and transplant operations to Congress every two years. The first report, which would be available to the public, is due in January 1987.

VA officials must compare the hospitals to safety norms and ``determine whether there are significant deviations from the standards that would indicate deficiencies in the quality of care.``

Whether patients would be able to obtain mortality rates from all VA hospitals upon demand remains unclear, however.

The bill, passed late Tuesday, contains provisions sponsored by Sen. Alan Cranston, D-Calif., to exempt VA death statistics from a federal law that makes secret many medical quality records.

Cranston introduced his bill last January after the VA refused to provide heart surgery death rates to the News and Sun-Sentinel. The newspapers have since filed suit to force disclosure.

But the bill permits the VA to shield death statistics if release would ``implicitly or explicitly`` reveal the safety record of a surgeon. VA officials claim the records of 15 of the agency`s 44 heart programs would be exempted because they are operated by a single surgeon.

The Senate bill also seeks to tighten scrutiny of the VA`s process for ensuring that VA doctors are properly trained.

The VA has been criticized recently for failing to report disciplinary actions taken against doctors to the Federation of State Medical Boards, a Texas-based computer data system that reports incompetent physicians to state licensing authorities.

The bill also requires the VA to ``allocate sufficient resources, and sufficient personnel, with the necessary skills and qualifications`` to inspect the quality of VA medical centers.

Other provisions would limit the size of new VA hospitals to 700 beds and set up pilot programs in 10 cities to treat ill veterans in their homes.